A client with type 2 diabetes mellitus is starting glipizide ...

[littleanan]

A client with type 2 diabetes mellitus is starting glipizide (Glucotrol) and metformin (Glucophage). Prior to giving the medication to the client, the nurse should assess for:
 
  1. history of cardiac disease.
  2. allergy to sulfonamides.
  3. history of renal failure.
  4. lesions on the lower limbs.

Question 2

A client with diabetes is in the office for a routine diabetic check. The nurse performs a glucose finger stick, which is 95, but notices that the client has a foot wound that is not healed.
 
  The nurse suspects that the client's blood sugar has been high, and plans to review the results of a:
 
  1. CBC.
  2. Fasting blood sugar.
  3. hemoglobin A1c.
  4. glucose tolerance test.

[tofugiraffe]

Answer to Question 1

Answer: 2

1. Since diabetes mellitus predisposes the client to cardiac issues due to high blood sugar and cholesterol, Glucotrol will decrease the risk. Glucotrol does not cause cardiac issues.
2. Glucotrol is a sulfonylurea and cannot be taken if the client has an allergy to sulfonamides.
3. A client with diabetes mellitus of any type is at risk for renal failure, and by controlling blood sugar, will help control the risk of renal failure.
4. Lesions on the lower limbs that do not heal are due to high blood sugar, which Glucotrol will help control.

Answer to Question 2

Answer: 3

1. The CBC will not give information about the client's glucose level.
2. A fasting blood sugar is one test that can diagnose diabetes mellitus.
3. The hemoglobin A1c gives the average blood sugar over about 3 months. Sometimes clients will make sure the blood sugar is low for a visit to the doctor, not realizing that the A1C gives the nurse and physician an idea of the client's average blood sugar and would also explain the inability of the wound to heal if the A1c were high.
4. If a client's fasting blood sugar were high, the doctor might order a glucose tolerance test to confirm the diagnosis.